Doctor Name: | MRS. JOY LOUISE BEVONI |
NPI Number: | 1003934027 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LPC |
License Number: | 20286 |
Business Practice Address: | 14023 State Highway 155 S Tyler, TX - 757036635 |
Business Phone Number: | 9035340414 |
Business Fax Number: | |
Mailing Address: | 13628 Gena Dr, TYLER |
State: | TX |
Postal Code: | 757095722 |
Phone Number: | 9035203533 |
Fax Number: | |
NPI Enumeration Date: | 03/27/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 20286 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |